For twenty months, Kyle Neo has been fed through a feeding tube. He cannot eat by mouth because of a swallowing complication that sends food into his lungs rather than his stomach. The procedure is called percutaneous endoscopic gastrostomy, known by the initials PEG, and places a tube in the stomach through an incision in the abdominal wall. For him, eating means blended food or milk delivered by syringe directly into the gastrointestinal system.
Accidents are common in this daily routine. The tube may be loose, the syringe is reused to save money, its lubrication dries out and then it needs a harder pull. At some point, the syringe breaks and the blended milk spills over his body and onto the kitchen floor. At those moments, he writes, he loses his patience “with being a patient.” He feels that eating has become feeding, as though he is caring for a baby who will never grow up.
He recognizes that many people with chronic conditions or disabilities, or those who are called on to deal mindfully with their emotions, experience something similar. Not necessarily spilled milk, but the repetition of the same unpleasant situations, which breeds frustration. Along with patience for illness, patience for mindfulness itself can run out. But being mindful does not mean never getting angry; mindfulness is a practice, not a personality trait.
He recounts a story about the Theravada teacher Ajahn Brahm. When asked what he would do if someone dropped a Buddhist holy book into a toilet, he joked that he would first call a plumber. Neo finds the answer full of humor and practicality. Getting angry when the practice goes wrong or is interrupted is useless. This kind of mindfulness takes a lot of practice, which is why he practices.
When milk spills from the feeding tube, he takes a deep breath and plans his next move: he inspects every corner where the milk spilled, cleans thoroughly and repeats the motions to make sure the space is clean. Mindfulness, combined with the lessons of the dharma, helps him interrupt the chain reactions that cause pain. The point is not to stop milk spilling from the tube, but to notice how much suffering he is about to pour into himself — and to know that he does not have to.
He explains the four foundations of mindfulness from the Satipaṭṭhāna Sutta: kāya, vedanā, citta and dhammā. Kāya brings attention back to the body. When something goes wrong with feeding, his mind is already racing ahead to cleaning up and preparing the next dose. Then he notices the shape of his hands gripping the syringe, the tension, the stickiness of his hands, his feet resting on a patterned floor, his breath moving in and out. This grounds him in the body as it is, rather than in all the places his mind has already traveled. And yes, he also notices that there is milk all over his shirt.
Vedanā concerns the immediate tone of experience: whether it is pleasant, unpleasant or neutral. As someone who likes cleanliness, he becomes irritated almost immediately when a feeding accident happens. But the practice continues after the first unpleasant feeling. The spilled milk is already there; anger does not make it any less spilled, nor does it clean his shirt. He tries to catch the displeasure before his mind turns it into something much bigger.
Citta means observing the state of the mind itself: is it angry, calm, distracted, greedy, clear or frustrated? Pretending he is not frustrated is not practice. Practice means recognizing the state without immediately identifying with it. Instead of becoming the frustration, saying “I am frustrated,” he can observe that “there is frustration here.” He also learns not to attribute his emotions to objects: the syringe that spilled the milk did not contain frustration; his mind added it.
Dhammā goes beyond the body, feeling and state of mind. Here, the patterns and teachings at work within experience and consciousness are observed. These include the so-called hindrances — sensual desire, ill will, sluggishness, restlessness and worry, and doubt — the aggregates of clinging, craving and aversion, the sense bases and the four noble truths: that suffering, duḥkha, is pervasive, that it has causes and conditions, that it is transient and that there is a path to freedom from it.
The four foundations do not occur in a fixed order; mindfulness is rarely that tidy. He starts with whichever foundation first comes into awareness, and another may then naturally reveal itself. Mindfulness is not a checklist, but recognizing what is happening as it happens. When he removes a little of the ego and the “I” from the experience, it becomes easier — not easy, easier.
And if all this analysis does not ground him, he asks the simplest question: after all this aversion, frustration and self-inflicted suffering, do I still have to clean up the milk? Unfortunately, yes. And he can clean up while suffering, or clean up without carrying so much duḥkha with him.
Comments